Milk is a regular dairy product in modern life. However, milk and many drugs can affect the absorption of drugs at the same time, and even interact with each other, leading to reduced efficacy. This is because on the one hand milk forms a layer of film on the surface of the drug and gastric mucosa. After the film is digested and absorbed, the drug has missed the best absorption period, thus reducing the absorption and efficacy of the drug.
In addition, milk can also cause adverse chemical or physical reactions with some drugs. Milk contains many inorganic salts, such as calcium, phosphorus, iron, vitamins, proteins, amino acids and fats, etc. Chemical substances easily react with drugs to form stable chromium complexes or insoluble salts. The drug is difficult to absorb, and severe cases can also develop gallstones and kidney stones.
Here are some examples of drugs that are specifically described:
I. Calcium, Zinc and Iron Preparations
Proteins in milk can form clots with calcium lactate, calcium gluconate, zinc gluconate, and other calcium and zinc preparations, which not only affect the absorption, lower the peak concentration of blood drug, but also aggravate it. Gastrointestinal burden. Iron preparations include ferrous succinate, ferrous fumarate, and ferrous gluconate. And phosphorus in milk can precipitate iron and can also affect iron absorption.
Iron is mainly absorbed in the duodenum and the proximal jejunum in the form of ferrous ions. The calcium ions in milk can compete with the iron in the site of duodenal absorption, resulting in reduced iron absorption and reduced efficacy. In addition, when the iron is used, bogey tea should be avoided to avoid being precipitated by the enamel. Therefore, patients should be confessed that taking iron preparations and milk should be separated by 1 to 2 hours.
II. Chinese Herbal Medicine or Chinese Patent Medicine
Traditional Chinese medicine and milk are not particularly suitable because they often contain sugar, polysaccharides, proteins, peptides, and amino acids, and some contain ginsenosides, glycyrrhizin, vitamins, volatile oils, organic acids, and trace elements. However, calcium, phosphorus, and iron in milk easily react with organic compounds in traditional Chinese medicines to form insoluble substances and destroy the active ingredients of milk and drugs. In addition, protein and fat in milk can also affect drug absorption.
III. Gastric mucosal protective agents and antacids
Commonly used metal ion-containing gastric mucosal protective agents and antacids are: aluminum hydroxide, magnesium hydroxide, calcium carbonate, sodium bicarbonate, aluminum magnesium carbonate, magnesium trisilicate, aluminum magnesium plus, potassium antimony bismuth, colloid Pectin, barium aluminate and its compound preparations.
Proteins in milk can form clots when combined with the above-mentioned metal ion-containing drugs, which not only reduces the efficacy of the drug, increases the burden on the gastrointestinal tract, but also affects the absorption of nutrients in milk. In addition, when sodium bicarbonate is combined with calcium-containing drugs and milk, milk-alkali syndrome can be caused.
IV. Most Antibacterials
Most antibiotics should not be taken with milk. Almost all quinolones, such as norfloxacin, levofloxacin, ciprofloxacin, etc., tetracycline drugs, combine with metal ions in milk to form insoluble chelates, affect absorption, reduce antibacterial effect, and reduce the efficacy of drugs, even Completely failed.
However, some drugs can be taken with milk, such as: amoxicillin, amoxicillin clavulanate, cefadroxil, cefaclor, clarithromycin, roxithromycin, minocycline can be served with milk .
V. Drugs for treating cardiovascular diseases
Such as for the treatment of chronic heart failure digoxin, digoxigenin and so on. If you are using medications and drinking large amounts of milk at the same time, the calcium ions in milk can increase the toxicity of these drugs and even cause accidents. The use of antihypertensive drugs such as Youjiangning, which is used by severe hypertensive patients, may lead to a sudden increase in blood pressure in connection with milk or milk products. In severe cases, blood pressure may continue to rise, and even hypertensive crisis may occur.
VI. Antiparkinsonian drugs
Anti-Parkinson’s disease drugs levodopa, carbidopa and their compound preparations should not be taken with milk. Levodopa is absorbed in the small intestine and needs help from the carrier when running in the body. Aromatic amino acids (such as phenylalanine) contained in milk proteins compete with levodopa for the same carrier system, thereby affecting its absorption.
Milk can not be taken at the same time as monoamine oxidase inhibitors in antidepressants because milk is rich in tyramine. When the enzyme is inhibited, tyramine accumulates in large amounts, causing a sudden rise in blood pressure, arrhythmia, and severe cases. Cerebral hemorrhage even died.
VIII. Treatment of Constipation Drugs
Bisacodyl is an irritant laxative for the treatment of acute and chronic constipation and habitual constipation. Milk can dissolve bisacodyl’s enteric coating prematurely, producing gastric or duodenal irritation. Therefore, do not drink milk for 2 hours before and after taking the medicine.
IX. Other drugs
Anticancer drugs estramustine, calcium and bone metabolism regulators (alendronate, ibandronate, pamidronate, ibandronate, clodronate, etc.), in any case can not contain Calcium or other divalent cations are served in milk, food, or medicine because they reduce the absorption of the drug.
In short, the medicine is best to use clean water, should not use milk, tea, etc. to send clothes, taking medicine and drinking milk need to be separated by one hour, taking the baby after taking the drug should also eat breast milk after a period of time, in order to avoid interaction, affect drug efficacy, Increase unnecessary side effects.